Kornimate/medical-research-clean huggingface dataset:
δvapco2 / cav02 ratio as a prognostic marker and predictor of complications after cardiac surgery

Conditions: Cardiac Surgery; Disorder of Blood Gas; Postoperative Complications; Shock

Summary: this study evaluates the usefulness of the δvapco2 / cav02 ratio to predict complications after elective cardiac surgery, comparing it with others markers such as lactate, arteriovenous co2 difference (δvapco2) and would try to developed a new predictive score for postoperative complications.

cardiac surgery is widely used to solve valvular or coronary problems and often requires the use of cardiopulmonary bypass or extracorporeal circulation (ec). the ec itself produces a series of changes in the macro- and microcirculation hemodynamic and physiological consequences in the hours following surgery that can be difficult to analyze. during postoperatively management, different monitoring methods are used to optimize different hemodynamic and analytical variables. sometimes, monitored variables are corrected but the patient still develops complications such as kidney failure, prolonged mechanical ventilation or even death. in fact, it is not well known either if it is sufficient to correct the variables called "macrodynamics " such as mean arterial pressure (map) , stroke volume (sv), pulmonary artery occlusion pressure (pcwp) and cardiac index (ci) or if it is necessary to correct other "micro-dynamics" variables like lactate, to achieve a certain central venous oxygen saturation (scvo2) or arteriovenous co2 difference(δvapco2). in tissue hypoxia, damping of excess protons by bicarbonate increase co2 production; therefore the relationship between co2 production and oxygen consumption (vco2/vo2 ratio or respiratory quotient) increases. this ratio can be simplified relating δvapco2 and o2 content arteriovenous difference (δvapco2 / cav02 ratio). in shock, anaerobic metabolism is one of the primary energy source. in this situation, δvapco2 / cav02 is \> 1. the evolution of the δvapco2 / cav02 ratio and its association with prognosis have nnot been studied yet after cardiac surgery. the study's objectives are: * to describe δvapco2 / cav02 ratios kinetics compared to lactate and other biochemical markers (troponin i, be) in the first 12 hours after cardiac surgery. * define if δvapco2 / cav02 ratio\> 1 after 6 hours of adequate postsurgical resuscitation correlates with worse prognosis in patients after cardiac surgery. * develop a new prognostic score for postoperative complication that includes δvapco2 / cav02 ratio. blood gases and drawn from a central venous and arterial lines. pco2, o2 content, lactate are analyzed at 0, 2, 6 and 12 hs. macrodynamic variables are also collected, as well as, the need of extracorporeal support techniques. patients would be followed for the next 28 days after surgery.

Eligibility criteria:
inclusion criteria: * 18 years old or more * given informed consent * elective cardiac surgery * tip of a central venous catheter correctly positioned (superior vena cava or right atria) * arterial catheter correctly positioned exclusion criteria: * pregnancy
a retrospective study on the effect of surgery on hip diseases

Conditions: Femoroacetabular Impingement; Acetabular Labral Tear

Summary: to study the effect of arthroscopy on the treatment of hip diseases and to evaluate the regularity and treatment of hip joint diseases.

to study the clinical effect of arthroscopic treatment in patients with hip disease, a retrospective study was conducted on 600 patients with hip disease from january 2011 to january 2016. all patients underwent preoperative examinations. these included preoperative supine anteroposterior hip radiographs, cross-lateral radiographs, computed tomography (ct), and magnetic resonance imaging.preoperative patient-reported outcomes (pros), including visual analogue scale (vas), international hip prognostic instrument-12 (ihot-12), and modified harris hip score (mhhs), were evaluated at 1, 2, and 5 years after surgery.

Eligibility criteria:
inclusion criteria: * the patient received imaging examination before surgery and was diagnosed with hip joint labrum injury, fai and other hip joint diseases, and the patient complained of pain in the hip joint, buttocks or thigh. conservative treatment is ineffective for more than 6 months. exclusion criteria: * history of hip surgery, hip osteoarthritis, femoral head necrosis, hip infection, rheumatic disease, lumbar disease, ankylosing spondylitis, or sacroiliac joint disease.
pupil-indexed noninvasive neuromodulation

Conditions: Paresis

Summary: vagus nerve stimulation (vns) is thought to activate neural pathways that release chemicals which promote plasticity and learning. previous work has shown that the auricular branch of the vagus nerve innervates landmarks on the external ear. work from the pi's laboratory has shown that electrical current applied to the external ear modulates physiological indexes of brain states implicated in the therapeutic effects of vns. the broad objective of this project is to better understand physiological mechanisms modulated by auricular stimulation to support possible therapeutic effects in the form of motor learning.

existing evidence supports the use of vns to enhance the effects of traditional therapy on impairments due to neurological injury. it is known that the vagus nerve forms contacts with neuromodulatory nuclei in the brainstem that release of chemicals shown to be critically involved in attentional control and memory formation. it is also known that the auricular branch of the vagus nerve innervates portions of the external ear providing a possible means to engage similar neural pathways noninvasively via transcutaneous auricular vagus nerve stimulation (tavns). recent work from the pi's laboratory shows that electrical current applied to landmarks on the external ear elicits transient effects on pupil dilation, an established physiological index of brain states that support learning. given the ability to engage the biomarker, the investigators aim to further investigate physiological mechanisms modulated by tavns and possible effects on learning.

Eligibility criteria:
inclusion criteria: all prospective subjects: 1. 18-75 years of age prospective subjects diagnosed with stroke: 2. diagnosis of a single stroke resulting in hand impairment 3. diagnosis of stroke at least six months prior to the time of participation exclusion criteria: all prospective subjects: 1. history of vestibular disorders or dizziness 2. difficulty maintaining alertness and/or remaining still 3. pregnant or expecting to become pregnant 4. diagnosis of neurological and/or musculoskeletal disorder(s) (other than stroke) that affect movement 5. ocular disease and/or impairment in more than one eye 6. history of seizure and/or epilepsy 7. implants, devices, or foreign objects in the brain/body that are incompatible with mri 8. body size that is incompatible with mri scanner dimensions 9. anyone already enrolled and actively participating in another greater than minimal risk study. prospective subjects diagnosed with stroke: 10. other impairments secondary to stroke (e.g., attention, cognition, etc.) that would interfere with the ability to understand study goals or follow simple instructions, as judged by the investigators.

Keywords: learning neurological rehabilitation
the impact of total knee arthroplasty surgical technique on coronal plane motion and patellofemoral articulation

Conditions: Osteoarthritis

Summary: the purpose of this study is to examine the impact of two surgical techniques on the outcome of the knee replacement surgery.

how stable a total knee replacement is depends on the correct and precise rotation of the femoral component. abnormal femoral component rotation has been associated with numerous adverse conditions including knee instability, knee pain, scar tissue, and abnormal knee motion. controversy exists, however, regarding the most favorable surgical technique to determine accurate femoral component rotation. some doctors prefer a measured resection technique in which landmarks on the femur bone are used to determine where to place the femoral component. others recommend a gap-balancing technique in which the femoral component is positioned by balancing the ligaments of the knee and placing it in the position where each ligament is equally strained. the purpose of this study is to examine the impact of the measured resection and gap-balancing surgical technique on how the total knee replacement moves and patient knee outcome scores. knee outcome scores are assessed from the responses given by patients to questions about outcomes associated with total knee replacement related to pain, symptoms, activities of daily living, sport and recreational function, and knee-related quality of life.

Eligibility criteria:
inclusion criteria: * surgeon and patient have determined that patient requires a primary total knee arthroplasty and agrees to participate and signs the informed consent for study. exclusion criteria: * history of alcoholism * unable to speak english * inflammatory arthritis * pregnant women or any woman with plans to begin a family.

Keywords: total knee replacement gap balanced measured resection
randomized, double blind, placebo control trial to evaluate the efficacy of wu-chu-yu tang on gastroesophageal reflux disease (gerd)

Conditions: Gastroesophageal Reflux Disease

Summary: gerd is due to gastric content reflux to esophagus cause symptom and complication including intra-esophagus such as reflux esophagitis, and extra-esophagus such as cough etc. because the changes of dietary habit, and improvement of examination skill and data analysis, the prevalence of gerd increased 2.5 multiple from 1995 to 2002, and suggesting the prevalence is 25% in taiwan community. although proton pump inhibitor (ppi) can inhibit gastric acid secretion, relief symptom and enhancing repair of esophageal damage, therefore, ppi is a main drug for the treatment of gred, but because of ppi has disadvantage of poor compliance, and slow gastric empty time and hypersensitivity, and about 40-50% of gerd patients is inefficacy. in addition, ppi produces bone fracture, community pneumonia and diarrhea in patient with long-term use. wu-chu-yu tang consists of evodia fargesii dode (evodia fruit), panax ginseng c. (ginseng), ziziphus jujube mill (chinses date), zingiber officinale rosee (fresh ginger). according to "i-fang-chi-chieh" and "shanghonzobinglun" recordings that wu-chu-yu tang can treat vomiting, and also can relax gastric tonicity and can enhance peristalsis of stomach. therefore, the purpose of the present study was to investigate the efficacy of wu-chu-yu tang on gred, and this effect of wu-chu-yu tang compared to ppi omeprazole.


Eligibility criteria:
inclusion criteria: 1. gender:male or female. 2. age: from 20 y/o to 75 y/o. 3. the diagnosis is gastroesophageal reflux disease. 4. with the symptoms of heartburn or acid regurgitation. 5. after explaining thoroughly the whole research purpose or process, the clients are willing to sign the agreement. exclusion criteria: 1. exclude peptic ulcer, gall bladder stone (including intraheptaic and common hepatical duct) and major diseased of cancer. 2. barrett's esophagus or esophagus stricture. 3. the operation history of esophagus or gastroduodenoal regions. 4. tarry stool suspected gi tract bleeding. 5. with the history of alcohol or drug abuse. 6. the clients with the history of study drug allergy. 7. the clients with psychologic cannot cooperate with each other. 8. the pregnant woman or the lactating women. 9. abnormal liver function such as got, gpt elevated over double the normal range.
collagen cross-linking in infectious keratitis trial

Conditions: Infectious Keratitis; Bacterial Keratitis; Fungal Keratitis

Summary: the purpose of this study is to evaluate the efficacy of collagen cross-linking for treatment of infectious keratitis.


Eligibility criteria:
inclusion criteria: * evidence of corneal ulcer grade ii or iii (bacteria or fungal, or presumed bacterial or fungal) * age more than 6 year * patients can understand and can follow the study protocol exclusion criteria: * pregnancy by history or urine test * evidence of herpetic keratitis * evidence of corneal perforation * evidence of autoimmune disease * known allergy to study medication

Keywords: corneal ulcer keratitis
safety and blood collection study of meningococcal b rlp2086 vaccine in adults

Conditions: Meningitis, Meningococcal

Summary: the purpose of this study is to evaluate the safety of an investigational meningococcal b rlp2086 vaccine in adults and to obtain blood samples from immunized subjects for use in assay development.


Eligibility criteria:
inclusion criteria: * healthy male or female subject between the ages of \>=18 and \<=40 years * negative urine pregnancy test for all female subjects of childbearing potential prior to test article administration and at the completion of the study. * all female or male subjects who are biologically capable of having children must agree to abstinence or commit to the use of a reliable method of birth control during for the duration of the study and for 30 days after early discontinuation. 4. hemoglobin levels \>=12.0 and \ =13.0 and \<=18.5 g/dl for male subjects. * blood pressure: systolic blood pressure \>90 and \ 60 and \<95 mm hg. * body weight \>=45 and \<=120 kg. * able to be contacted by telephone during the study period. exclusion criteria: * pregnancy or breastfeeding women * prior vaccination with a serogroup b meningococcal vaccine. * a previous anaphylactic or severe vaccine-associated adverse reaction. * a known hypersensitivity to any study vaccine components. * a known or suspected disease of the immune system or those receiving immunosuppressive therapy, including systemic corticosteroids (excluding topical, inhalation and intra-articular corticosteroids). * bleeding diathesis or condition associated with prolonged bleeding time that would contraindicate intramuscular injection. * receipt of any blood products, including gamma globulin, in the period from 6 months before study vaccination through the study conclusion. * receipt of an inactivated vaccine within 14 days before study vaccinations and live attenuated vaccine within 28 days before study vaccination. this will apply throughout the study until the last vaccination. * any clinically significant chronic disease that, in the investigator's judgment may be worsened by blood draw. * received any investigational drug, vaccine or device within the 30-day period before study visit 1 and during the conduct of the study. * history of culture-proven invasive disease caused by n meningitidis or n gonorrhoea.

Keywords: mnb rlp2086 blood collection vaccination
the incidence of infection in treatment of low-dose il-2 of sle patients

Conditions: Infection

Summary: il-2 is a pleiotropic cytokine which can regulate or stimulate the differentiation and function of cd4+, cd8+ and nk cells. an opened-labelled trial and a retrospective study have indicated the incidence of infection is lower in the treatment of low-dose il-2 combined with corticosteroid and immunosuppressor. we are going to conduct a multi-center prospective observational study to verify the above results.

we are going to conduct a multi-center prospective observational study, and plan to enroll 500 sle patients. low-dose il-2 is defined as 100iu il-2 injected subcutaneously every other day for two weeks, followed by two-week break as one treatment cycle, and at least three weeks.there will be 250 patients in low-dose il-2 group which treat with il-2 combined with steroid and immunosuppressor. non-il-2 group is only treat with steroid and immunosuppressor. these patients are followed by every one month until get infected, otherwise, patients will be followed for two years. we focus on the type, positive microorganisms, grade and treatment of infection. then, we will compare the differences of above parameters between these two groups.

Eligibility criteria:
inclusion criteria: * sle patients diagnosed by the acr criteria of 1987; * treated with low-dose il-2, corticosteroid and immunosuppressor for sle. * consent to participate in this study. * regular follow-up for at least 2 years. exclusion criteria: * other autoimmune disease; * without treatment of low-dose il-2, corticosteroid and immunosuppressor for sle. * mental disorder without regular or specific treatment.
immune-based therapy pilot study for the treatment of primary hiv infection (phi-imd).

Conditions: HIV

Summary: pilot study for the treatment of primary hiv infection with the objective to induce a strong specific hiv immune response able to control viral replication without haart.

pilot and open rct in 20 patients with primary hiv-1 infection who were randomized to one of these two arms: 1) control arm (a), tenofovir +lamivudine + lopinavir-ritonavir (kaletra) at standard doses for 44 weeks (w44); a short treatment interruption (ti) was performed at w36, and haart was restarted for 8 weeks when plasma hiv-1 rna viral load (pvl) rebounded\>200 copies/ml. at w44 haart was stopped and patients were followed for 48 additional weeks (w92). 2) immune-based arm (b), same haart schedule plus oral cyclosporine a (csa)(serum levels 250-350 mcg/l) for the first 8 weeks of haart. during the ti, patients received sc gm-csf (250 mcg tiw) plus weekly sc pegylated-interferon a2b (peg-inf)(1.5 mcg/kg/week). during the last 8 weeks of haart (until w44), patients received daily sc low-dose interleukin-2 (il-2)(0.75 mu/kg qd). the primary endpoint was pvl \<1000copies/ml (\<3.0 log10/ml) at 12 (w56) and at 48 (w92) weeks after stopping haart. sample size was calculated in order to detect a pvl difference of 1.5log10 copies/ml at 12 (w56) weeks after stopping haart between the control and the immune-based arms with a power of 80% and a level of significance of0.05.

Eligibility criteria:
inclusion criteria: 1. hiv-infected patients (age 18 years or over) with primary hiv infection \<90 days. 2. giving written informed consent to participate into the study. exclusion criteria: 1. patients not accepting to start haart. patients wishing start haart treatment with nevirapine or efavirenz. 2. pregnant women or planning pregnancy. 3. intravenous drug user or alcohol abuse. 4. previous treatment with cyclosporin a, gm-csf,pegylated-interferon-alpha o interleukine-2. 5. renal or liver failure. 6. any formal contraindication to treatment with the study drugs. 7. patients with a history of psychiatric disorder, thyroid illness, dislipidemia requiring treatment, cardiovascular disease, arterial hypertension, or diabetes mellitus. 8. in treatment with drugs interacting with study drugs. 9. acute infection for htlv-i or ebv.
comparison of two under knee lower limb bypass types:endothelialised prosthesis versus autologous vein graft

Conditions: Arteritis

Summary: the aim of this project is to improve the hemocompatibility of vascular prosthesis with a complete covering of its endoluminal surface with autologous endothelial cells. the objective is to obtain a better bypass permeability with arterial prosthesis replacing low diameter vessels in lower limbs

physiological vascular endothelium is an hemocompatible and thrombus resistant surface and none of the materials used for revascularisation owns these properties. the aim of this project is to improve the hemocompatibility of vascular prosthesis with a complete covering of their endoluminal surface with autologous endothelial cells. this strategy, that plans to associate an artificial component of synthetic origin and cellular component is a bioartificial vascular substitute concept. first results obtained by an austrian team are really encouraging (with more than 100 patients during last 10 years). thus, the main objective of this study is to compare efficacy in terms of grafts with endothelialised ptfe prosthesis with great saphenous autologous vein graft for under knee arterial popliteal revascularisation of lower limbs. this is a phase iii, randomised equivalent trial. it is open labelled, with 2 parallel well balanced groups. forty patients will be randomised. a short segment of the cephalic vein will be cut and some blood will be sampled in patients randomised in the eptfe group. endothelial cells of the cephalic vein will be isolated, cultured, with autologous serum, and then amplified before sowing of the internal face of ptfe prosthesis, previously covered with a biological glue clinically validated. before prosthesis implantation, systematic quality controls will be performed. implantation will be planned 3 weeks after venous sampling. eventual failure of cellular culture or prosthesis covering will lead to an autologous vein graft. people randomised in the second group will receive an autologous saphenous vein graft. the primary outcome is to demonstrate the equivalence of time dependent permeability rate between endothelialized ptfe and autologous vein graft. equivalence between both technics would allow to preserve autologous saphenous vein for later distal bypasses (where it is the best technic) or for coronary bypasses.

Eligibility criteria:
inclusion criteria: age above 18, male or female, ii to iv arteritis level with intermittent limping, under knee femoro popliteal bypass indication. available saphenous vein, no major trophic trouble, no contra indication to the use of prosthesis. - exclusion criteria: -

Keywords: arteritis, femoro popliteal bypass, endothelialised prosthesis, saphenous vein graft, permeability, doppler echography
potential diagnostic biomarkers for aortic dissection in the emergency department

Conditions: Aortic Dissection

Summary: the goal of this observational study is to determine the utility of desmosine, d-dimer and aggrecan as early diagnostic biomarkers in aortic dissection. the main questions it aims to answer are: * to investigate the plasma levels of selected biomarkers in ed patients with confirmed aortic dissection * to study the diagnostic performance of plasma levels of selected biomarkers for aortic dissection * to study the association between plasma levels of selected biomarkers and clinical outcomes


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * presentation to the ed with first 24 hours of symptoms suggesting ad, including chest pain, upper back pain, syncope of unknown cause, symptoms of any acute perfusion deficit * confirmed ad * the diagnosis of ad adjudicated by an independent expert panel at hospital discharge or death, whichever comes first * the expert panel will consist of (1) a specialist in emergency medicine and (2) a specialist in cardiology and (3) a specialist in cardiothoracic surgery. exclusion criteria: * age \<18 years old * pregnancy * surgery or stenting performed before recruitment

Keywords: aortic dissection biomarker diagnostic d-dimer aggrecan desmosine
prevalence of intracranial aneurysm in hong kong chinese

Conditions: Intracranial Aneurysm

Summary: intracranial aneurysm (localized dilatation in weakened blood vessel wall) rupture is a catastrophic disease, with half of the victims died and many of the survivors disabled. there is currently no data in the literature for the chinese population concerning the prevalence, characteristics (location and size) and risk of harboring an unruptured intracranial aneurysm. in this study, the investigators aim to study the population prevalence and characteristics (location and size) of intracranial aneurysm in hong kong chinese, and its cost-effectiveness. the screening is carried out using magnetic resonance angiography (mra), with a 3-t magnetic resonance system, which is a well-established non-invasive method for intracranial aneurysm detection.

as charted below.

Eligibility criteria:
inclusion criteria: * healthy adults aged between 21 and 65 years exclusion criteria: * contraindications to mri * history of known intracranial pathologies

Keywords: chinese intracranial aneurysm magnetic resonance imaging